BERRYSBURG, Pa. (AP) -- Ephriam Blank Jr. stands on his farmhouse porch in northern Dauphin County,

BERRYSBURG, Pa. (AP) -- Ephriam Blank Jr. stands on his farmhouse porch in northern Dauphin County, his two young children nearby, his buggy and barn and animals before him, his cancer unseen but growing inside him.
He has no health insurance. People close to him say his medical bills could reach half a million dollars.
But Blank will not say he needs outside financial help. He fends off money questions with noncommittal answers.
He is Amish. His people do not rely on the outside "English" community for help.
His illness, though, is testing that credo. And it is drawing attention to the rapidly growing Amish community in the Lykens Valley.
The first Amish arrived 25 to 30 years ago. Now, according to leading Amish businessmen, there are 1,000 or more living in the scenic, rolling landscape nestled between the east-west humps of Berry Mountain and Mahantango Mountain.
They continue to seek its relative seclusion, and to escape high-priced, tourist-trampled Lancaster County. And a whole new generation has been born and raised in Dauphin County since the start of the influx into Upper Paxton, Mifflin, Washington and Lykens townships.
"There are a lot of them ... More of them every day," said Ray Deppen Jr., a Lykens Township supervisor.
How they live
Like their Lancaster brethren, the Dauphin County Amish are known for being hardworking, disciplined and fair. They do not drive automobiles, use electricity or have telephones in their homes. They have their own schools.
Some life events, though, propel them into mainstream society. And one of those is complex medical care.
"When we really get to face the reality of the modern world is when we have a hospital bill," said Levi Esh, an Amish businessman who owns a shoe store in the heart of the new Amish country.
Blank is 28. He has testicular cancer that has spread to his stomach, according to his sister, Amanda King.
Already, her brother has endured multiple bouts of chemotherapy, surgery and treatment by doctors at Johns Hopkins University Hospital in Baltimore and Memorial Sloan-Kettering Cancer Center in New York City.
Now, King said, Blank is embarking on a series of stem cell transplants at Penn State Milton S. Hershey Medical Center.
Doctors have been amazed at her brother's physical stamina in the face of his illness, according to King. At the same time, she said, "the cancer is so fast-growing it is unbelievable."
Blank's medical expenses are expected to reach $500,000, according to Esh, family friend Nancy Michaelian and others close to the Blank family.
The Amish forgo medical insurance. According to Esh, they typically rely on Amish charity and a church aid plan to pay medical bills.
But Blank's case, he said, has pushed that system to its limits. A fund for donations to help with his medical bills has been established at Gratz National Bank.
Blank declined to talk about the fund. He confirmed the nature of his cancer and the plan for treatments at Hershey, but he declined to give details.
View of publicity
Publicity goes against the Amish ethic of humility, according to Donald B. Kraybill, an educator and author of numerous books on the Amish.
They see publicity as a form of pride and pride as a form of sin, Kraybill said.
In Blank's case, though, other cultural forces might be at work. Some Amish, Kraybill said, prefer a more natural or homegrown approach to medicine, while others seek modern, sophisticated treatments.
Kraybill said Blank's pursuit of cutting-edge cancer therapies might have created ripples within his own community.
"There may be some members who feel that one should simply yield to the will of God and not make such heroic interventions at this stage," Kraybill said.
Michaelian and King, an Air Force staff sergeant who left the Amish order in 1988, said Blank wants to live so he can watch his children grow.
Non-Amish might be willing to donate to Blank's fund.
His people have woven themselves into the fabric of everyday life in northern Dauphin County, creating favorable impressions.
"We deal with probably most of the Amish in this valley, and they are good people to deal with," said Timothy Allison, vice president of the Gratz bank. "I have a lot of respect for them. You look at their properties and they are well taken care of. They have created jobs for the non-Amish community."
The Amish run farms and businesses. They get hired for construction and carpentry jobs. They often hire "English," as they refer to non-Amish, to drive them places.
"They are very well-received. The businesses they run are very much frequented," said Katy Olinger, a Millersburg-area resident for nearly 40 years.
Berrysburg resident Betty Sultzbaugh said many young Amish have joined the fire company.
"They aren't afraid of working, I'll tell you that," she said, "boys and girls."